EP1458434B1 - Dispositif non invasif de mesure de la temperature du sang circulant dans un circuit extracorporel, et equipement associe - Google Patents

Dispositif non invasif de mesure de la temperature du sang circulant dans un circuit extracorporel, et equipement associe Download PDF

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Publication number
EP1458434B1
EP1458434B1 EP02805865A EP02805865A EP1458434B1 EP 1458434 B1 EP1458434 B1 EP 1458434B1 EP 02805865 A EP02805865 A EP 02805865A EP 02805865 A EP02805865 A EP 02805865A EP 1458434 B1 EP1458434 B1 EP 1458434B1
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EP
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Prior art keywords
temperature
blood
measuring
line
equipment according
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EP02805865A
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German (de)
English (en)
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EP1458434A1 (fr
Inventor
Francesco Fontanazzi
Francesco Paolini
Massimo Zaccarelli
Giorgio De Cicco
Annalisa Delnevo
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Gambro Lundia AB
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Gambro Lundia AB
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3623—Means for actively controlling temperature of blood
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/367—Circuit parts not covered by the preceding subgroups of group A61M1/3621
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01J—MEASUREMENT OF INTENSITY, VELOCITY, SPECTRAL CONTENT, POLARISATION, PHASE OR PULSE CHARACTERISTICS OF INFRARED, VISIBLE OR ULTRAVIOLET LIGHT; COLORIMETRY; RADIATION PYROMETRY
    • G01J5/00—Radiation pyrometry, e.g. infrared or optical thermometry
    • G01J5/0037—Radiation pyrometry, e.g. infrared or optical thermometry for sensing the heat emitted by liquids
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01J—MEASUREMENT OF INTENSITY, VELOCITY, SPECTRAL CONTENT, POLARISATION, PHASE OR PULSE CHARACTERISTICS OF INFRARED, VISIBLE OR ULTRAVIOLET LIGHT; COLORIMETRY; RADIATION PYROMETRY
    • G01J5/00—Radiation pyrometry, e.g. infrared or optical thermometry
    • G01J5/02—Constructional details
    • G01J5/04—Casings
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01J—MEASUREMENT OF INTENSITY, VELOCITY, SPECTRAL CONTENT, POLARISATION, PHASE OR PULSE CHARACTERISTICS OF INFRARED, VISIBLE OR ULTRAVIOLET LIGHT; COLORIMETRY; RADIATION PYROMETRY
    • G01J5/00—Radiation pyrometry, e.g. infrared or optical thermometry
    • G01J5/02—Constructional details
    • G01J5/06—Arrangements for eliminating effects of disturbing radiation; Arrangements for compensating changes in sensitivity
    • G01J5/061—Arrangements for eliminating effects of disturbing radiation; Arrangements for compensating changes in sensitivity by controlling the temperature of the apparatus or parts thereof, e.g. using cooling means or thermostats
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01J—MEASUREMENT OF INTENSITY, VELOCITY, SPECTRAL CONTENT, POLARISATION, PHASE OR PULSE CHARACTERISTICS OF INFRARED, VISIBLE OR ULTRAVIOLET LIGHT; COLORIMETRY; RADIATION PYROMETRY
    • G01J5/00—Radiation pyrometry, e.g. infrared or optical thermometry
    • G01J5/10—Radiation pyrometry, e.g. infrared or optical thermometry using electric radiation detectors
    • G01J5/12—Radiation pyrometry, e.g. infrared or optical thermometry using electric radiation detectors using thermoelectric elements, e.g. thermocouples
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01K—MEASURING TEMPERATURE; MEASURING QUANTITY OF HEAT; THERMALLY-SENSITIVE ELEMENTS NOT OTHERWISE PROVIDED FOR
    • G01K1/00—Details of thermometers not specially adapted for particular types of thermometer
    • G01K1/14—Supports; Fastening devices; Arrangements for mounting thermometers in particular locations
    • G01K1/143—Supports; Fastening devices; Arrangements for mounting thermometers in particular locations for measuring surface temperatures
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01K—MEASURING TEMPERATURE; MEASURING QUANTITY OF HEAT; THERMALLY-SENSITIVE ELEMENTS NOT OTHERWISE PROVIDED FOR
    • G01K11/00—Measuring temperature based upon physical or chemical changes not covered by groups G01K3/00, G01K5/00, G01K7/00 or G01K9/00
    • G01K11/006—Measuring temperature based upon physical or chemical changes not covered by groups G01K3/00, G01K5/00, G01K7/00 or G01K9/00 using measurement of the effect of a material on microwaves or longer electromagnetic waves, e.g. measuring temperature via microwaves emitted by the object
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3368—Temperature

Definitions

  • the present invention relates to a non-invasive device for measuring blood temperature in a circuit for the extracorporeal circulation of blood, and to equipment provided with this device.
  • a dialysis machine uses a filter having a first compartment, in which the blood flows, and a second compartment, in which there flows a dialysate which may be at a temperature different from the blood temperature.
  • the two compartments are separated from each other by a semi-permeable membrane which allows heat to be transferred from the blood to the dialysate and vice versa. For this reason also, the problem of monitoring the blood temperature is very important in the field of dialysis machines. Similar problems arise when haemofiltration and haemodiafiltration treatments are carried out.
  • the temperature of the line and therefore of the blood flowing in it is related to the temperature of the aluminium element by a known relation and can be determined from the signal supplied by the thermistor.
  • the transducer formed in this way (the aluminium element and the thermistor) is inserted into a support, also made from aluminium, which is kept at the same temperature as the line by a heater controlled by a suitable control unit.
  • the heat exchange between the transducer and the external enviromnent is minimized, and the measured temperature depends solely on the heat exchange with the line.
  • the space between the transducer and the heated support is filled with a material (for example, PVC) chosen in such a way as to optimize the compromise between the speed of response of the sensor and the thermal insulation from the external environment.
  • a material for example, PVC
  • a device according to the preamble of claim 1 is known, for example, from US-A-4 894 164.
  • the known systems have a number of drawbacks. This is because the lines forming the extracorporeal circuit are normally made from material with low thermal conductivity, in order to prevent a damaging loss of heat. The thermal coupling between the blood flowing within the extracorporeal circuit and the aluminium element is therefore poor, and the measurement made in the way that has been described is inevitably of low accuracy. In particular, the known systems have very long response transients, since a variation in blood temperature is detected only after a new state of thermal equilibrium has been established among the blood flow, the wall of the extracorporeal circuit, the transducer and the heated support.
  • the object of the present invention is to provide a non-invasive device for measuring the blood temperature in a circuit for the extracorporeal circulation of blood, which is free of the drawbacks of the known art.
  • a non-invasive device for measuring blood temperature in a circuit for the extracorporeal circulation of blood, this device comprising a line in which blood taken from a patient flows, and a temperature sensor, connected to the said line and generating a first signal correlated with the temperature of the blood flowing in the said line, characterized in that the said temperature sensor comprises a device for measuring the intensity of an electromagnetic radiation, and the said line comprises a connecting portion facing the said measuring device and permeable by electromagnetic radiation in a first wave band; the said first signal being correlated with the intensity of the said electromagnetic radiation in the said first band.
  • the device according to the invention advantageously permits the measurement of a quantity directly correlated with the patient's blood temperature, namely the electromagnetic radiation emitted by the blood at a certain temperature in a predetermined frequency band.
  • the portion of the extracorporeal circuit on which the measurement is made is connected to the sensor in such a way that the fraction of electromagnetic radiation emitted by the blood and incident on the measuring device is maximized.
  • the devices for measuring electromagnetic radiation comprising a thermopile in a preferred embodiment of the invention, have very short response transients. The device therefore has very high precision, accuracy and speed of response.
  • the blood temperature can be measured with an error of less than 0.1 °C and with transients of the order of hundredths of a second.
  • the present invention also relates to control equipment in an extracorporeal blood circuit, as specified in Claim 20.
  • the invention is used for monitoring the blood temperature during a dialysis treatment.
  • the number 1 indicates the whole of a dialysis machine connected to a patient P.
  • the machine 1 comprises an extracorporeal blood circuit 2, a filter 3 including a blood compartment 5 and a dialysate compartment 6 separated by a semi-permeable membrane 7, a dialysate circuit 8 connected to the dialysate compartment 6, an infusion circuit 9 and equipment 10 for regulating the blood temperature.
  • the extracorporeal blood circuit 2 comprises an arterial branch 11, in which a peristaltic pump 12 is located, and a venous branch 13.
  • the arterial branch 11 has one end connected to the blood compartment 5 and one end connected to a fistula (not illustrated) in the patient P to collect the blood from the cardiovascular system of the patient P, while the venous branch 13 has one end connected to the blood compartment 5 and an opposite end fitted into the aforesaid fistula (not illustrated) to return the treated blood to the cardiovascular system of the patient P.
  • the branches 11 and 13 are tubes made from plastic material, used, respectively, for supplying the blood to be treated to the compartment 5 and for introducing into the cardiovascular system the treated blood leaving the compartment 5.
  • the infusion circuit 9 is connected to a pre-dilution node 15a, located in the arterial branch 11, and to a post-dilution node 15b, located in the venous branch 13, and supplies a controlled quantity of an infusion solution to the extracorporeal circuit 2, in a known way.
  • the infusion circuit 9 is connected only to the pre-dilution node 15a or only to the post-dilution node 15b.
  • the device 18 regulates the blood temperature in the portion 13a without adding mass to the blood flow.
  • the regulating device 18 acts on a fluid which is separated physically from the blood and whose temperature T F is monitored by the unit 16a in a range from 20°C to 43°C in such a way as to supply heat to, or remove it from, the blood flowing in the venous branch 13 directly before the blood is returned to the patient P.
  • the regulating device 18 comprises at least one line 18a, which forms a set of windings or a nest of tubes and provides a seat 18b for housing the portion 13a of the venous branch 13, and a heater/cooler 18c connected to the control unit 16a.
  • the blood is collected from the patient P and is conveyed along the extracorporeal circuit 2.
  • the non-invasive device 16 measures the temperature T P and the control unit 16a controls the regulating device 18, on the basis of a predetermined algorithm, as a function of the temperature T P and a reference temperature T SET which is set by an operator at the control unit 16a.
  • control unit 16a compares the temperature T P with the reference temperature T SET , which is generally 37°C, and calculates the temperature difference ⁇ T between the temperature T P and the reference temperature T SET .
  • the regulating device 18 keeps the temperature T F of the fluid at a value equal to the reference temperature T SET , while the temperature T D of the dialysate is regulated in such a way as to optimize the haemodialysis treatment.
  • the blood temperature T in the extracorporeal circuit 2 varies as a result of the heat exchange with the surrounding environment, with the dialysate, and with the fluid conveyed within the regulating device 18, and as a function of the reaction of the patient P to the materials used in the treatment of the blood.
  • the temperature T P is measured by the non-invasive device 16, for example, at relatively short time intervals during the dialysis treatment, and the control unit 16a calculates the temperature difference ⁇ T at the same frequency as that of the measurement of the temperature T P .
  • the temperature difference ⁇ T between the temperature T P and the reference temperature T SET takes a negative value
  • the fluid temperature T F is increased in such a way as to supply heat to the blood in the portion 13a
  • the temperature difference ⁇ T takes a positive value
  • the fluid temperature T F is reduced in such a way as to remove heat from the blood in the portion 13a.
  • the sensor 17 detects the state of operation of the pump 12 and emits a signal to indicate when the pump 12 is operational and when it is stopped. If the signal emitted by the sensor 17 indicates that the pump 12 is in a stopped state, the control unit 16a keeps the value of T F equal to the reference temperature T SET ; if, on the other hand, the signal indicates that the pump 12 is in an operational state, the fluid temperature T F is regulated as a function of the temperature difference ⁇ T according to the procedure described above.
  • the reference temperature T SET is not fixed, but varies during the dialysis treatment according to a specified profile.
  • the device 16 comprises a temperature sensor 19, a line 20 fitted in the arterial branch 11 and connected to the sensor 19, and the digital and/or analogue control unit 16a.
  • the sensor 19 comprises a thermopile 21 and a temperature control device 22.
  • the thermopile 21 is housed within a casing 23 ( Figure 4), in a window 24 formed in the said casing 23, and has a pair of measuring terminals 25 connected to the control unit 16a. Between these terminals 25 there is a voltage V B correlated with the intensity of the electromagnetic radiation striking the thermopile 21 through the window 24 and having a predetermined measurable waveband B S , at least partially included in the infrared band IR ( Figure 5).
  • the operating principle of a thermopile is based on the Seebeck effect.
  • the thermopile 21 preferably has a plurality of hot junctions 21a and cold junctions 21b connected together in series, as shown in Figure 6.
  • the hot junctions 21a are located in an area of absorption 21c which absorbs the incident electromagnetic radiation and modifies its own temperature as a result.
  • the cold junctions 21b are supported by a support 21d of semiconductor material placed in contact with the casing 23 ( Figure 4) in which the thermopile 21 is housed.
  • the voltage V B generated by the thermoelectric effect is a function of the temperature difference between the hot junctions 21a and the cold junctions 21b, in other words between the absorption area 21 c and the support 21d.
  • the temperature of the support 21 d, on which the cold junctions 21b are located must be kept at a value sufficiently lower than the operating temperature range within which the thermopile 21 is to be used.
  • control device 22 which keeps the casing 23 and consequently the support 21d at a controlled and constant operating temperature, in the range from 5°C to 15°C and preferably at 10°C,
  • control device 22 comprises a thermistor 28 ( Figure 4), a solid-state heat pump 29 and a control circuit 30, preferably integrated in the control unit 16a ( Figure 2).
  • the thermistor 28 is located within the casing 23 and is thermally connected to the cold junctions 21b of the thermopile 21 by means of the casing 23 and the support 21d; additionally, the thermistor 28 has a pair of terminals 31 connected to the control circuit 30 and supplying an electrical signal S TP , correlated with the operating temperature of the thermopile 21.
  • the heat pump 29 is a thermoelechic module, for example a Peltier cell, which causes heat to be transferred between its two opposite surfaces when an electrical current passes through it, and therefore has a cold surface 32 and a hot surface 34 ( Figures 2 and 3).
  • the cold surface 32 is connected to the casing 23 of the thermopile 21 by means of a heat-conducting support 33 (made from copper, for example), which is pierced so that it can house the thermopile 21.
  • the hot surface 34 is connected to a heat sink 35 to promote the dispersion of the heat extracted by the said heat pump 29.
  • the heat pump 29 also has a pair of terminals 36 connected to the control circuit 30, which, in a known way, supplies a control current I C correlated with the electrical signal S TP .
  • the line 20, in which the blood collected from the patient P flows comprises a connecting portion 37, facing the thermopile 21 and permeable by the electromagnetic radiation in the measurable band B S .
  • the connecting portion 37 is of discoid shape and is completely superimposed on the window 24 of the casing 23 in which the thermopile 21 is housed, in such a way that it completely covers the solid angle of view of the thermopile 21.
  • the connecting portion 37 is made from a material having negligible absorbance and high transmittance in the measurable band B S and in a temperature range from 30°C to 40°C.
  • this material is chosen from high-density polyethylene, low-density polyethylene and poly(4-methyl-1-pentene) (PMP).
  • PMP poly(4-methyl-1-pentene)
  • a filter 38 comprising a sheet of a material which is essentially opaque to electromagnetic radiation outside a pass band B P lying within the measurable band B S ( Figure 5), is interposed between the thermopile 21 and the line 20 ( Figures 2 and 3).
  • the filter 38 is supported by the casing 23, and has a first face 39 positioned so that it covers the window 24, and a second face 40, opposite the first face 39 and facing the connecting portion 37 of the line 20.
  • the filter 38 is made from suitably treated germanium, and the pass band B P is in the range from 8 ⁇ m to 14 ⁇ m (infrared).
  • the blood collected from the cardiovascular system of the patient P flows through the line 20 and emits electromagnetic radiation in the measurable band B S .
  • a fraction of the electromagnetic radiation emitted through the filter 38 and the window 24 strikes the thermopile 21, thus contributing to the determination of the value of the voltage V B between the terminals 25.
  • the variations of the voltage V B are due exclusively to the variations of intensity of the electromagnetic radiation which is emitted by the blood flowing in the connecting portion 37 and which strikes the thermopile 21.
  • thermopile 21 Since the connecting portion 37 is positioned so that it entirely covers the solid angle of view of the thermopile 21 through the window 24, the flow of electromagnetic radiation through the window 24 is essentially due solely to the electromagnetic radiation emitted by the blood flowing in the connecting portion 37; additionally, the casing 23 of the thermopile 21 is kept at a constant known temperature by means of the device 22, and consequently makes a constant contribution to the voltage V B .
  • the intensity of the radiation is also correlated with the temperature T P of the body by which it is emitted, in other words the blood of the patient P. More specifically, the total power of the emitted infrared radiation is a function of the temperature of the radiating body, according to the Stefan-Boltzmann law. The intensity of the emitted radiation increases with an increase in the temperature of the radiating body.
  • the filter 38 selects only the electromagnetic radiation lying within the pass band B P , and the voltage V B generated by the thermopile 21 depends on the energy absorbed in this pass band B P .
  • the number 45 indicates a haemofiltration machine comprising the extracorporeal circuit 2 and a haemofiltration filter 46 comprisilig a blood compartment 47 and a compartment 48 separated by a semi-permeable membrane 49.
  • the machine 45 is equipped with the blood monitoring equipment 10 and, in particular, is provided with the non-invasive device 16.
  • the machine 45 can carry out pure haemofiltration treatments and haemofiltration treatments in pre- and/or post-dilution.
  • the equipment 10 applied to the machine 45 is completely identical to that associated with the machine 1, and its operation is also identical.
  • the equipment 10 is particularly advantageous in that it can be connected to any type of blood purification machine, and does not require adaptation to the type of purification treatment in use.
  • the use of the invention is not limited to dialysis machines alone, but can be extended to all cases in which a circuit for extracorporeal blood circulation is used. It is also possible to use infrared radiation measuring devices other than those described, such as devices made from semiconductor material with PN junctions.
  • the non-invasive device could also be provided with a dedicated control unit, separate from that which is used to control the other parts of the equipment for regulating the blood temperature.
  • the heat pump used can also be different from a Peltier cell.

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  • Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • General Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Spectroscopy & Molecular Physics (AREA)
  • Vascular Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Cardiology (AREA)
  • Electromagnetism (AREA)
  • Urology & Nephrology (AREA)
  • Emergency Medicine (AREA)
  • External Artificial Organs (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
  • Measuring Temperature Or Quantity Of Heat (AREA)

Claims (32)

  1. Dispositif non invasif pour mesurer la température du sang dans un circuit pour la circulation extracorporelle de sang, ledit dispositif comprenant un tuyau (20) dans lequel s'écoule le sang prélevé d'un patient (P), et un senseur de température (19) relié au dit tuyau (20) et générant un premier signal (VB) lié à la température (TP) du sang s'écoulant dans ledit tuyau, caractérisé en ce que ledit senseur de température (19) comprend un dispositif (21) pour mesurer l'intensité d'une radiation électromagnétique, et ledit tuyau (20) comprenant une portion de connexion (37) placée en face dudit dispositif de mesure (21) et perméable aux radiations électromagnétiques dans une première bande d'onde (BS); ledit premier signal (VB) étant lié à l'intensité de ladite radiation électromagnétique dans ladite première bande (BS).
  2. Dispositif selon la revendication 1, caractérisé en ce que ledit dispositif de mesure (21) est logé dans un logement (23), derrière une fenêtre (24) formée dans ledit logement (23); ladite portion de connexion (37) du dit tuyau (20) se superposant complètement à ladite fenêtre (24), de sorte qu'elle couvre complètement l'angle solide de vue dudit dispositif de mesure (21).
  3. Dispositif selon la revendication 1 ou 2, caractérisé en ce que ledit dispositif de mesure (21) comprend une thermopile ayant au moins une soudure chaude (21a) et au moins une soudure froide (21b).
  4. Dispositif selon la revendication 3, caractérisé en ce que ledit senseur de température (19) comprend des moyens (22) de contrôle de la température, afin de maintenir la soudure froide (21b) dudit dispositif de mesure (21) à une température contrôlée (T0).
  5. Dispositif selon la revendication 4, caractérisé en ce que lesdits moyens de contrôle (22) comprennent:
    - un thermistor (28) relié thermiquement à la soudure froide (21 b) dudit dispositif de mesure (21) et délivrant un deuxième signal (STP) lié à ladite température contrôlée (T0);
    - une pompe de chaleur à état solide (29) ayant une surface à basse température (32) relié thermiquement audit dispositif de mesure (21), et une surface à haute température (34); et
    - un circuit de contrôle (30) relié audit thermistor (28), afin de recevoir ledit deuxième signal (STP), et à ladite pompe de chaleur (29), afin de délivrer un signal de contrôle (IC) lié audit deuxième signal (STP).
  6. Dispositif selon la revendication 5, caractérisé en ce que ladite pompe de chaleur (29) comprend une celle de Peltier.
  7. Dispositif selon la revendication 5 ou 6, caractérisé en ce que il comprend un élément dissipateur de chaleur (35) placé en contact avec ladite surface à haute température (34) de ladite pompe de chaleur (29).
  8. Dispositif selon une quelconque des revendications 5-7, caractérisé en ce que ladite température contrôlée (T0) est une température constante dans l'intervalle de 5°C à 15°C.
  9. Dispositif selon une quelconque des revendications précédentes, caractérisé en ce que ladite portion de connexion (37) est construite avec un matériel ayant un facteur de transmission essentiellement constant et une absorbance négligeable dans ladite première bande d'onde (BS).
  10. Dispositif selon une quelconque des revendications précédentes, caractérisé en ce que ladite portion de connexion (37) est construite avec un matériel ayant un facteur de transmission essentiellement constant dans un intervalle de température de 30°C à 40°C.
  11. Dispositif selon une quelconque des revendications précédentes, caractérisé en ce que ladite portion de connexion (37) est construite avec un matériel choisi du groupe comprenant le polyéthylène à haute densité, le polyéthylène à basse densité et le poly(4-méthyl-1-pentène).
  12. Dispositif selon une quelconque des revendications précédentes, caractérisé en ce que il comprend des moyens de filtration (38) placés entre ledit dispositif de mesure (21) et ladite portion de connexion (37) du dit tuyau (20).
  13. Dispositif selon la revendication 12, caractérisé en ce que lesdits moyens de filtration (38) comprennent une couche de matériel étant essentiellement opaque aux radiations électromagnétiques hors d'une deuxième bande d'onde (BP) contenue à l'intérieur de ladite première bande d'onde (BS).
  14. Dispositif selon la revendication 13, caractérisé en ce que ladite deuxième bande d'onde (BP) est comprise dans l'intervalle de 8 µm à 14 µm.
  15. Dispositif selon la revendication 13 ou 14, caractérisé en ce que lesdits moyens de filtrations (38) sont en germanium.
  16. Dispositif selon une quelconque des revendications 12-15, caractérisé en ce que lesdits moyens de filtration (38) ont une face (40) placée en face de ladite portion de connexion (37) de ladite ligne (20).
  17. Dispositif selon une quelconque des revendications précédentes, caractérisé en ce que ladite première bande d'onde (BS) est contenue au moins partiellement dans la bande de radiations infrarouges (IR).
  18. Dispositif selon la revendication 4, caractérisé en ce que il comprend une unité de contrôle (16a) associée audit senseur de température (19), afin de recevoir ledit premier signal (VB) et de déterminer ladite température du sang (Tp) selon une relation du type: T P = F ( V B ) + T 0 .
    Figure imgb0007
  19. Dispositif selon la revendication 18, caractérisé en ce que ladite relation est la suivante: T P = K * V B + T 0 ,
    Figure imgb0008
     où K est une constant déterminée de façon expérimentale.
  20. Appareil de contrôle pour un circuit sanguin extracorporel (2), dans lequel le circuit extracorporel (2) est relié à une machine de purification du sang (1; 45) et comprend une ramification artérielle (11) et une ramification veineuse (13) reliées à au moins un élément de traitement du sang (3; 3, 15a; 3, 15b; 45; 45, 15a; 45, 15b), l'appareil (10) étant caractérisé en ce que il comprend un dispositif non invasif (16) pour mesurer la température du sang (Tp) selon au moins une des revendications 1 à 19.
  21. Appareil selon la revendication 20, caractérisé en ce que le dispositif non invasif (16) a un senseur (19) pour mesurer une première température (TP) du sang en sortie d'un patient (P) le long de la ramification artérielle (11) en amont dudit élément de traitement du sang (3; 3, 15a; 3, 15b; 45; 45, 15a; 45, 15b), une unité de contrôle (16a) pour régler la température du sang (T) en fonction de la première température (TP) et d'une température de référence (TSET), et un dispositif (18) pour régler la température du sang (T) relié à une portion (13a) de la ramification veineuse (13) en aval dudit élément de traitement du sang (3; 3, 15a; 3, 15b; 45; 45, 15a; 45, 15b).
  22. Appareil selon la revendication 21, caractérisé en ce que ledit dispositif de réglage (18) est combiné avec ladite portion (13a) en formant un échangeur de chaleur; ladite unité de contrôle (16a) étant reliée audit dispositif de réglage de la température (18).
  23. Appareil selon la revendication 21 ou 22, caractérisé en ce que ledit dispositif de réglage (18) comprend un tuyau (18a) de transport d'un liquide qui peut être chauffé à une température (TF) comprise dans un intervalle spécifié, proche à 37°C.
  24. Appareil selon une des revendications 21 à 23, caractérisé en ce que ledit dispositif de réglage (18) a un siège (18b) pour loger ladite portion (13a) de la ramification veineuse (13).
  25. Appareil selon une des revendications 21 à 24, caractérisé en ce que ledit circuit extracorporel (2) est relié à une pompe (12) pour transporter le sang le long du circuit extracorporel (2), l'appareil (10) comprenant un senseur (17) pour détecter l'état opérationnel de la pompe (12); l'unité de contrôle (16a) maintenant la température (TF) dudit liquide égale à ladite température préétablie (TSET) lorsque la pompe (12) n'est pas en marche.
  26. Appareil selon une des revendications 21 à 25, caractérisé en ce que ladite ramification veineuse a un noeud de post-dilution (15b); ladite portion (13a) étant placée en aval dudit noeud de post-dilution (15b).
  27. Appareil selon une des revendications 21 à 26, caractérisé en ce que ledit élément de traitement du sang (3; 3, 15a; 3, 15b) se compose d'un filtre d'hémodialyse (3) comprenant un compartiment du sang (5) et un compartiment du dialysat (6) dans lequel s'écoule un dialysat.
  28. Appareil selon une des revendications 21 à 26, caractérisé en ce que ledit élément de traitement du sang (3; 3, 15a; 3, 15b) comprend un filtre d'hémodialyse (3) comprenant un compartiment du sang (5) et un compartiment du dialysat (6) dans lequel s'écoule un dialysat, et un noeud de pré- ou post-dilution (15a; 15b) pour l'introduction d'un liquide de substitution.
  29. Appareil selon une des revendications 21 à 26, caractérisé en ce que ledit élément de traitement du sang (45; 45, 15a; 45, 15b) se compose d'un filtre d'hémofiltration (45).
  30. Appareil selon une des revendications 21 à 26, caractérisé en ce que ledit élément de traitement du sang (45; 45, 15a; 45, 15b) comprend un filtre d'hémofiltration (45) et un noeud de pré- ou post-dilution (15a, 15b) pour l'introduction d'un liquide de substitution.
  31. Appareil selon la revendication 21, caractérisé en ce que ladite unité de contrôle (16a) règle la température (T) en fonction de la première température (TP) et de la température de référence (TSET) à des intervalles de temps préétablis.
  32. Appareil selon la revendication 21 ou 31, caractérisé en ce que ladite unité de contrôle (16a) règle la température (T) en fonction de la différence entre la première température (TP) et la température de référence (TSET).
EP02805865A 2001-12-28 2002-12-20 Dispositif non invasif de mesure de la temperature du sang circulant dans un circuit extracorporel, et equipement associe Expired - Lifetime EP1458434B1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
IT2001MI002828A ITMI20012828A1 (it) 2001-12-28 2001-12-28 Dispositivo non invasivo per il rilevamento della temperatura ematicain un circuito per la circolazione extracorporea del sangue e apparato
ITMI20012828 2001-12-28
PCT/IB2002/005572 WO2003055544A1 (fr) 2001-12-28 2002-12-20 Dispositif non invasif de mesure de la temperature du sang circulant dans un circuit extracorporel, et equipement associe

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US20050094704A1 (en) 2005-05-05
EP1458434A1 (fr) 2004-09-22
AU2002367115B2 (en) 2007-08-16
ATE329637T1 (de) 2006-07-15
CA2470874A1 (fr) 2003-07-10
KR100938455B1 (ko) 2010-01-25
ITMI20012828A1 (it) 2003-06-28
KR20040071271A (ko) 2004-08-11
ES2266639T3 (es) 2007-03-01
US7648475B2 (en) 2010-01-19
JP4300113B2 (ja) 2009-07-22
AU2002367115A1 (en) 2003-07-15
DE60212448D1 (de) 2006-07-27
DE60212448T2 (de) 2006-12-14
CA2470874C (fr) 2010-08-10
WO2003055544A1 (fr) 2003-07-10

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